Acute group A streptococcal infections and sequelae (pediatrics) Quiz: Ace Your Exams
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A nine-year-old boy presents to the emergency department for evaluation of dark-colored urine and puffiness around his eyes and bilateral leg swelling that was noticed today. His mother reports that he has been less active than usual with decreased appetite. The family recently returned from a trip to Kenya visiting family. The patient has no significant past medical history. Temperature is 37°C (98.6°F), pulse is 94/min, respiratory rate is 14/min, blood pressure is 140/95 mmHg, and oxygen saturation is 99% on room air. Physical examination reveals periorbital edema. Cardiopulmonary examination is unremarkable. There is 2+ pitting edema up to the mid calves bilaterally. Laboratory studies are shown below. Which of the following is most likely to be revealed after taking a detailed history?
| Laboratory value | Result |
| Bloodwork | |
| Sodium | 142 mEq/L |
| Potassium | 4.2 mEq/L |
| Chloride | 95 mEq/L |
| Creatinine | 2.1 mg/dL |
| Albumin | 3.2 g/dL |
| Hemoglobin | 12 g/dL |
| Platelet | 400,000 mm/3 |
| Anti-streptolysin (ASO) | Elevated |
| Urinalysis | |
| Color | Dark brown |
| Specific gravity | 1.013 |
| Glucose | Negative |
| Protein | Moderate |
| Blood | Moderate |
| Leukocyte esterase | Negative |
| Red blood cells | 20-30/hpf |
| Casts | RBC casts |
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